VasectomyPain.Org

When a man has a vasectomy, his body continues to produce sperm. There is nowhere for this sperm to go and while some of it is reabsorbed, the amount produced can present some problems. In many men, this sperm builds up in the tail of the epididymus (a mushy sperm maturation organ connected to the testes). This leads to leaks in the epididymal lining. Sperm can then leak into areas they were never meant to be, and stimulate a different and stronger antibody response than is normal and seen during puberty.

You see, sperm is highly antigenic, meaning it stimulates a strong immune response. It is recognized by the man's body as foreign. During puberty, some anti-sperm antibodies develop when the body is first exposed to sperm. Prior to this, the man's immune system has never “seen” sperm. After puberty, the sperm are protected by a “blood-testes barrier”. When this barrier is broken by vasectomy and sperm are “presented” to the immune system, new anti-sperm antibodies are formed and the previous “normal” immune response becomes abnormal in strength, specific antibody types, and perseverance of response. At present, the consensus view appears to be that there are no proven short term or long term deleterious effects from anti-sperm antibodies other than decreased fertility after vasectomy reversal. Some people have raised concerns...

 

Abstract: OBJECTIVE. To determine whether or not there is an association between testicular histologic changes and antisperm antibodies in vasectomized men. METHODS. Morphometry was performed on testicular biopsy specimens obtained from 19 vasectomized men and 21 fertile control subjects. Antisperm antibody status was determined on the serum of each patient and control subject using the indirect immunobead assay. RESULTS. Significant increases in seminiferous tubule wall thickness (p < 0.001), focal interstitial fibrosis (p < 0.001), and percent composition of interstitium (p < 0.01) were observed in vasectomized men as compared with control subjects. Serum antisperm activity was present in 74 percent of the vasectomized men but none in the control subjects (p < 0.001). There was no association between testicular histologic changes and immune status. CONCLUSIONS. Vasectomized men exhibit significant testicular histologic changes and increased autoimmune activity as compared with fertile control subjects. These histologic changes are not directly associated with antisperm antibody status, suggesting that some other pathophysiologic process must be responsible. Jarow JP, Goluboff ET, Chang TS, Marshall FF. Relationship between antisperm antibodies and testicular histologic changes in humans after vasectomy. Urology 1994;43:521-4.

 

The development by a large percentage of vasectomized men of sperm autoantibodies is discussed in this monograph chapter. The production of anti-sperm antibodies is attributed to: 1) granuloma formation; 2) increased permeability of epithelial barriers in the rete testis and epididymis; and 3) transport of phagocytic cells to regional lymph nodes. Individual variation in type of antibodies and response to antibody production is documented and is thought to depend on such factors as rate of sperm production, the structure of the blood-testis barrier, surgical technique, and expression of immune response genes. Morphological changes in spermatozoa and testes occurring after vasectomy may be induced by immunological mechanisms. Tests of cell-mediated immunity to sperm antigens are described, and more accurate tests are needed. Animal studies provide evidence that chronic immune stimulation can result in formation of circulating immune complexes, resulting in deleterious systemic effects, including damage to kidneys, blood vessels, and cells of the immune system. Further studies of the autoimmune orchitis phenomenon may aid in avoidance of immunologically mediated side effects of vasectomy. Clin Obstet Gynaecol. 1979 Dec;6(3):425-42.

Vasectomy is a widely accepted surgical procedure for male sterilization, with the unique characteristic of eliciting immune responses to self-antigens. Persistent humoral autoimmune responses to spermatozoa and transient responses to other antigens have been demonstrated in vasectomized men. Little information is available on delayed hypersensitivity reactions to spermatozoa, as well as histopathology and immunohistopathology of the testes and other organs in vasectomized individuals. Overall, the data obtained in men do not point to any immediate cause for concern and seem to justify the optimistic view that vasectomy is a safe procedure. A review of the studies performed in experimental animals similarly shows that vasectomy is followed by humoral and/or cell-mediated immune responses to spermatozoal antigens. In some species, such as rabbits and guinea pigs, it is also followed by testicular lesions, mediated by in situ immune complexes and/or delayed hypersensitivity reactions. Other sequelae may be glomerulonephritis and an increased severity of atherosclerotic lesions. Therefore, the rather encouraging picture emerging from the human studies is to a certain extent offset by the findings in experimental animals. Additional research on the effects of vasectomy is obviously necessary, as well as caution in advising this procedure to individuals who may be genetically predisposed to autoimmune disease. Prog Clin Biol Res. 1981;70:461-76.